Notes

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In cases with scapholunate dissociation and ulnar impaction syndrome, treatment should be directed toward both. When done with careful pre-operative evaluation and planning in one setting, can yield favorable results.
Leprosy is a chronic granulomatous infection, classically presents with cutaneous and neurological manifestations. Joint involvement in leprosy can present as acute symmetrical or chronic polyarthritis with or without tenosynovitis resembling rheumatoidarthritis.

We report a rare case of lepromatous hip arthritis in a 32-year-old male, known case of leprosytenosynovitis and symmetrical polyarthritis of hands and feet 3 weeks after appearance of typical cutaneous lesion. The patient was started on anti-leprosy and steroid treatment. After 9 months of treatment and recurrent exacerbation of symptoms, the patient developed bilateral hip pain. selleck products Hip pain was diagnosed as bilateral avascular necrosis hip on magnetic resonance imaging which progressed to the left hip arthritis later on. The patient underwent staged total hip arthroplasty (THA) for the left hip arthritis, with debridement and antibiotic spacer in the first stage and final hip prosthesis in the second stage.

Leprosy can present with large joint-like hip involvement including tenosynovitis and acutesymmetrical polyarthritis. Two-stage THA is an alternative treatment option for patients with advanced arthritis of the hip under some difficult conditions. The Harris hip score was increased from 35 preoperatively to 91.5 at the final follow-up.
Leprosy can present with large joint-like hip involvement including tenosynovitis and acutesymmetrical polyarthritis. Two-stage THA is an alternative treatment option for patients with advanced arthritis of the hip under some difficult conditions. The Harris hip score was increased from 35 preoperatively to 91.5 at the final follow-up.
Osteogenic sarcoma of patella is extremely rare and only few cases have been reported in the literature so far. Limb salvage, particularly reconstructing extensors of the knee, is a matter of debate in available literature. Henceforth, we would like to present this uncommon case of patellar osteosarcoma in a young female managed by chemotherapy and wide excision without extensor mechanism reconstruction.

A 25-year-old female had a history of painless swelling around the left knee for 6 months, which was progressively increasing in size. It was diagnosed as osteoblastic osteosarcoma patella radiologically, confirmed by open biopsy. The patient was managed by recommended protocol comprising neoadjuvant chemotherapy followed by tumor excision, thereafter chemotherapy in post-operative period. However, no reconstruction of the extensor mechanism was done. At 1-year follow-up, the patient was able to perform activities of daily living without any discomfort. She was able to ambulate unaided with no extensor lag.

For managing a case with osteosarcoma patella, chemotherapy along with optimal excision comprising total patellectomy without extensor mechanism reconstruction is a viable option.
For managing a case with osteosarcoma patella, chemotherapy along with optimal excision comprising total patellectomy without extensor mechanism reconstruction is a viable option.
Combined subtrochanteric femur fracture with anterior dislocation of hip is a very rare injury to occur with subminimal reported cases available in the literature. This study report describes one such unusual case presentation.

A 26-year-old gentleman presented to our emergency room following road traffic accident, complained of severe pain over his right hip and inability to move his right lower limb. The hip was diffusely swollen and the lower limb externally rotated, clinical and radiological evaluation revealed anterior dislocation of the right hip with ipsilateral subtrochanteric femur fracture. Emergency closed reduction of the right hip was performed using joystick maneuver with two Schanz pins and concomitantly the subtrochanteric fracture reduced, and uniplanar external fixator was applied on the same day of presentation. Following 2 days, external fixator removal and IMIL nailing were performed as an elective definitive procedure. The patient was regularly followed up both clinically and radiologically from the index procedure until now with 2 years as follow-up.

Anterior hip dislocation with ipsilateral subtrochanteric femur fracture in a young adult requires early emergency evaluation and rapid intervention (reduction within 6 h) and early closed reduction of the joint helps decreasing the risk of complications such as avascular necrosis and chondrolysis and joint reduction with fracture fixation allows early rehabilitation.
Anterior hip dislocation with ipsilateral subtrochanteric femur fracture in a young adult requires early emergency evaluation and rapid intervention (reduction within 6 h) and early closed reduction of the joint helps decreasing the risk of complications such as avascular necrosis and chondrolysis and joint reduction with fracture fixation allows early rehabilitation.
Myxoid soft tissue tumors consist of a heterogeneous group of mesenchymal neoplasms with a hallmark of the abundant extracellular myxoid matrix. Intramuscular myxomas are rare benign tumor affecting the musculoskeletal system. The common sites include the thigh, upper arm, calf, and the buttocks. Magnetic resonance imaging is the radiological modality of choice in diagnosing these cases, while tissue biopsy is the gold standard.

A 70-year-old male presented to orthopedics out-patient department with complaints of a humongous swelling engulfing his right thigh all around. The gradual and progressive appearance of burning sensations and rest pain around the affected area with difficulty in bearing weight, over the past 6-7 months forced him to seek medical attention. Biopsy and imaging were performed followed by final excision. The tumor was removed En-bloc and post-operative period was uneventful. The patient did not show any signs recurrence and was asymptomatic until the final followup of 26 months.

Myxomatous swelling mimics an intramuscular lipoma, sarcoma, hematoma, or a hemangioma and must be carefully evaluated. En-bloc excision without spillage is the treatment of choice which ensures long and lasting recovery.
Myxomatous swelling mimics an intramuscular lipoma, sarcoma, hematoma, or a hemangioma and must be carefully evaluated. En-bloc excision without spillage is the treatment of choice which ensures long and lasting recovery.
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